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1.
Cancer Immunol Res ; 3(2): 161-72, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25271151

RESUMO

Tryptophan catabolism by indoleamine 2,3-dioxygenase 1 (IDO1) plays a key role in tumoral resistance to immune rejection. In humans, constitutive expression of IDO1 has been observed in several tumor types. However, a comprehensive analysis of its expression in normal and tumor tissues is still required to anticipate the risks and potential benefits of IDO1 inhibitors. Using a newly validated monoclonal antibody to human IDO1, we performed an extensive immunohistochemical analysis of IDO1 expression in normal and tumor tissues. In normal tissues, IDO1 was expressed by endothelial cells in the placenta and lung and by epithelial cells in the female genital tract. In lymphoid tissues, IDO1 was expressed in mature dendritic cells with a phenotype (CD83(+), DC-LAMP(+), langerin(-), CD123(-), CD163(-)) distinct from plasmacytoid dendritic cells. Importantly, IDO1-expressing dendritic cells were not enriched in tumor-draining lymph nodes, in contrast with previously reported findings. IDO1-expressing cells were observed in a large fraction (505/866, 58%) of human tumors. They comprised tumor cells, endothelial cells, and stromal cells in proportions that varied depending on the tumor type. Tumors showing the highest proportions of IDO1-immunolabeled samples were carcinomas of the endometrium and cervix, followed by kidney, lung, and colon. This hierarchy of IDO1 expression was confirmed by gene expression data mined from The Cancer Genome Atlas database. Expression of IDO1 may be used to select tumors likely to benefit from targeted therapy with IDO1 inhibitors.


Assuntos
Biomarcadores Tumorais/metabolismo , Indolamina-Pirrol 2,3,-Dioxigenase/metabolismo , Proteínas de Neoplasias/metabolismo , Neoplasias/imunologia , Animais , Anticorpos Monoclonais/biossíntese , Anticorpos Monoclonais/imunologia , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/imunologia , Células Cultivadas , Células Dendríticas/imunologia , Feminino , Perfilação da Expressão Gênica/métodos , Regulação Neoplásica da Expressão Gênica/imunologia , Genitália Feminina/imunologia , Humanos , Indolamina-Pirrol 2,3,-Dioxigenase/genética , Indolamina-Pirrol 2,3,-Dioxigenase/imunologia , Pulmão/imunologia , Linfonodos/imunologia , Metástase Linfática , Camundongos Endogâmicos BALB C , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/imunologia , Neoplasias/genética , Placenta/imunologia , Gravidez , RNA Mensageiro/genética
2.
J Immunol ; 192(4): 1962-71, 2014 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-24453253

RESUMO

Peptide splicing is a novel mechanism of production of peptides relying on the proteasome and involving the linkage of fragments originally distant in the parental protein. Peptides produced by splicing can be presented on class I molecules of the MHC and recognized by CTLs. In this study, we describe a new antigenic peptide, which is presented by HLA-A3 and comprises two noncontiguous fragments of the melanoma differentiation Ag gp100(PMEL17) spliced together in the reverse order to that in which they appear in the parental protein. Contrary to the previously described spliced peptides, which are produced by the association of fragments of 3-6 aa, the peptide described in this work results from the ultimate association of an 8-aa fragment with a single arginine residue. As described before, peptide splicing takes place in the proteasome by transpeptidation involving an acyl-enzyme intermediate linking one of the peptide fragment to a catalytic subunit of the proteasome. Interestingly, we observe that the peptide causing the nucleophilic attack on the acyl-enzyme intermediate must be at least 3 aa long to give rise to a spliced peptide. The spliced peptide produced from this reaction therefore bears an extended C terminus that needs to be further trimmed to produce the final antigenic peptide. We show that the proteasome is able to perform the final trimming step required to produce the antigenic peptide described in this work.


Assuntos
Melanoma/metabolismo , Complexo de Endopeptidases do Proteassoma/metabolismo , Processamento de Proteína/fisiologia , Antígeno gp100 de Melanoma/genética , Animais , Células COS , Linhagem Celular Tumoral , Chlorocebus aethiops , Antígeno HLA-A3/genética , Antígeno HLA-A3/imunologia , Antígeno HLA-A3/metabolismo , Humanos , Melanoma/genética , Melanoma/imunologia , Fragmentos de Peptídeos/genética , Linfócitos T Citotóxicos/imunologia , Antígeno gp100 de Melanoma/imunologia , Antígeno gp100 de Melanoma/metabolismo
3.
Bioorg Med Chem Lett ; 23(1): 47-54, 2013 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-23218716

RESUMO

Tsitsikammamines are marine alkaloids whose structure is based on the pyrroloiminoquinone scaffold. These and related compounds have attracted attention due to various interesting biological properties, including cytotoxicity, topoisomerase inhibition, antimicrobial, antifungal and antimalarial activity. Indoleamine 2,3-dioxygenase (IDO1) is a well-established therapeutic target as an important factor in the tumor immune evasion mechanism. In this preliminary communication, we report the inhibitory activity of tsitsikammamine derivatives against IDO1. Tsitsikammamine A analogue 11b displays submicromolar potency in an enzymatic assay. A number of derivatives are also active in a cellular assay while showing little or no activity towards tryptophan 2,3-dioxygenase (TDO), a functionally related enzyme. This IDO1 inhibitory activity is rationalized by molecular modeling studies. An interest is thus established in this class of compounds as a potential source of lead compounds for the development of new pharmaceutically useful IDO1 inhibitors.


Assuntos
Indolamina-Pirrol 2,3,-Dioxigenase/antagonistas & inibidores , Pirróis/química , Quinolinas/química , Alcaloides/síntese química , Alcaloides/química , Alcaloides/toxicidade , Sítios de Ligação , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Humanos , Indolamina-Pirrol 2,3,-Dioxigenase/metabolismo , Simulação de Acoplamento Molecular , Estrutura Terciária de Proteína , Pirróis/síntese química , Pirróis/toxicidade , Quinolinas/síntese química , Quinolinas/toxicidade , Relação Estrutura-Atividade
4.
J Immunol ; 188(5): 2102-10, 2012 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-22291187

RESUMO

The uptake and long-term cross-presentation of tumor Ag long peptides (LP) by dendritic cells (DC) make them attractive cancer vaccine candidates. However, it remains to be established whether LP can prime long-lived tumor-reactive CTL and whether other cell types are able to cross-present them. Using HLA-A2 healthy donor and melanoma patient-derived PBMC, we studied the in vitro cross-priming potential of Melan-A 16-40 LP bearing the HLA-A2-restricted epitope 26-35 or its analog 26-35(A27L) and compared it to the priming capacity of the short analog. We then addressed LP priming capacity in vivo using HLA-A2 mice. We also studied LP cross-presentation by monocyte-derived DC, plasmacytoid DC, monocytes, and B cells. We showed that the modified LP gave rise to high and sustained cross-presentation by monocyte-derived DC. This led to cross priming in vitro and in vivo and to expansion of long-lived tumor-reactive cytotoxic T cells. In contrast, the LP containing the natural 26-35 epitope primed specific T cells poorly, despite its long-lived cross-presentation, and T cells primed against the short analog were short-lived. We further showed that LP cross-presentation is restricted to monocytes and conventional DC. These results document for the first time, to our knowledge, the strong immunogenicity of a human tumor Ag LP. Of note, they underscore that this property is critically dependent on sufficient HLA binding affinity and/or TCR ligand potency of the cross-presented epitope. We conclude that LP fulfilling this requirement should be used as tumor vaccines, together with DC maturating agents, especially the Melan-A 16-40(A27L) LP, for the treatment of HLA-A2(+) melanoma patients.


Assuntos
Neoplasias Colorretais/imunologia , Apresentação Cruzada/imunologia , Epitopos de Linfócito T/metabolismo , Antígeno HLA-A2/metabolismo , Antígeno MART-1/metabolismo , Melanoma/imunologia , Fragmentos de Peptídeos/metabolismo , Linfócitos T Citotóxicos/imunologia , Sequência de Aminoácidos , Animais , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Vacinas Anticâncer/farmacologia , Vacinas Anticâncer/uso terapêutico , Linhagem Celular Tumoral , Células Cultivadas , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Epitopos de Linfócito T/fisiologia , Antígeno HLA-A2/fisiologia , Humanos , Epitopos Imunodominantes/metabolismo , Epitopos Imunodominantes/fisiologia , Ativação Linfocitária/imunologia , Antígeno MART-1/fisiologia , Melanoma/patologia , Melanoma/terapia , Camundongos , Camundongos Mutantes , Dados de Sequência Molecular , Monócitos/imunologia , Monócitos/metabolismo , Fragmentos de Peptídeos/fisiologia , Linfócitos T Citotóxicos/metabolismo , Linfócitos T Citotóxicos/patologia
5.
Proc Natl Acad Sci U S A ; 109(7): 2497-502, 2012 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-22308364

RESUMO

Tryptophan catabolism mediated by indoleamine 2,3-dioxygenase (IDO1) is an important mechanism of peripheral immune tolerance contributing to tumoral immune resistance, and IDO1 inhibition is an active area of drug development. Tryptophan 2,3-dioxygenase (TDO) is an unrelated hepatic enzyme that also degrades tryptophan along the kynurenine pathway. Here, we show that enzymatically active TDO is expressed in a significant proportion of human tumors. In a preclinical model, TDO expression by tumors prevented their rejection by immunized mice. We developed a TDO inhibitor, which, upon systemic treatment, restored the ability of mice to reject TDO-expressing tumors. Our results describe a mechanism of tumoral immune resistance based on TDO expression and establish proof-of-concept for the use of TDO inhibitors in cancer therapy.


Assuntos
Neoplasias/imunologia , Triptofano Oxigenase/antagonistas & inibidores , Animais , Linhagem Celular Tumoral , Humanos , Camundongos , Triptofano Oxigenase/metabolismo
6.
J Med Chem ; 54(15): 5320-34, 2011 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-21726069

RESUMO

Tryptophan catabolism mediated by indoleamine 2,3-dioxygenase (IDO) is an important mechanism of peripheral immune tolerance contributing to tumoral immune resistance. IDO inhibition is thus an active area of research in drug development. Recently, our group has shown that tryptophan 2,3-dioxygenase (TDO), an unrelated hepatic enzyme also catalyzing the first step of tryptophan degradation, is also expressed in many tumors and that this expression prevents tumor rejection by locally depleting tryptophan. Herein, we report a structure-activity study on a series of 3-(2-(pyridyl)ethenyl)indoles. More than 70 novel derivatives were synthesized, and their TDO inhibitory potency was evaluated. The rationalization of the structure-activity relationships (SARs) revealed essential features to attain high TDO inhibition and notably a dense H-bond network mainly involving His(55) and Thr(254) residues. Our study led to the identification of a very promising compound (58) displaying good TDO inhibition (K(i) = 5.5 µM), high selectivity, and good oral bioavailability. Indeed, 58 was chosen for preclinical evaluation.


Assuntos
Antineoplásicos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Fatores Imunológicos/farmacologia , Indóis/farmacologia , Triptofano Oxigenase/antagonistas & inibidores , Animais , Antineoplásicos/síntese química , Antineoplásicos/uso terapêutico , Disponibilidade Biológica , Linhagem Celular , Desenho de Fármacos , Humanos , Indóis/síntese química , Indóis/uso terapêutico , Cinética , Camundongos , Neoplasias/enzimologia , Relação Estrutura-Atividade
7.
Eur J Med Chem ; 46(7): 3058-65, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21419531

RESUMO

Indoleamine 2,3-dioxygenase (IDO) is an important new therapeutic target for the treatment of cancer. With the aim of discovering novel IDO inhibitors, a virtual screen was undertaken and led to the discovery of the keto-indole derivative 1a endowed with an inhibitory potency in the micromolar range. Detailed kinetics were performed and revealed an uncompetitive inhibition profile. Preliminary SARs were drawn in this series and corroborated the putative binding orientation as suggested by docking.


Assuntos
Antineoplásicos/química , Inibidores Enzimáticos/química , Indolamina-Pirrol 2,3,-Dioxigenase/antagonistas & inibidores , Indóis/química , Simulação de Acoplamento Molecular , Proteínas de Neoplasias/antagonistas & inibidores , Animais , Linhagem Celular Tumoral , Bases de Dados de Compostos Químicos , Descoberta de Drogas , Ensaios Enzimáticos , Escherichia coli/genética , Expressão Gênica , Ensaios de Triagem em Larga Escala , Humanos , Indolamina-Pirrol 2,3,-Dioxigenase/química , Indolamina-Pirrol 2,3,-Dioxigenase/genética , Camundongos , Proteínas de Neoplasias/química , Proteínas de Neoplasias/genética , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Relação Estrutura-Atividade , Triptofano/química
8.
Bioorg Med Chem ; 19(4): 1550-61, 2011 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-21269836

RESUMO

Indoleamine 2,3-dioxygenase (IDO) is a heme dioxygenase which has been shown to be involved in the pathological immune escape of diseases such as cancer. The synthesis and structure-activity relationships (SAR) of a novel series of IDO inhibitors based on the indol-2-yl ethanone scaffold is described. In vitro and in vivo biological activities have been evaluated, leading to compounds with IC(50) values in the micromolar range in both tests. Introduction of small substituents in the 5- and 6-positions of the indole ring, indole N-methylation and variations of the aromatic side chain are all well tolerated. An iron coordinating group on the linker is a prerequisite for biological activity, thus corroborating the virtual screening results.


Assuntos
Etano/química , Indolamina-Pirrol 2,3,-Dioxigenase/antagonistas & inibidores , Indóis/química , Indóis/farmacologia , Domínio Catalítico , Linhagem Celular , Humanos , Indolamina-Pirrol 2,3,-Dioxigenase/química , Modelos Moleculares , Domínios e Motivos de Interação entre Proteínas , Relação Estrutura-Atividade
9.
PLoS One ; 5(7): e11894, 2010 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-20689590

RESUMO

BACKGROUND: We previously demonstrated that the matrix metalloproteinase-2 (MMP-2) contained an antigenic peptide recognized by a CD8 T cell clone in the HLA-A*0201 context. The presentation of this peptide on class I molecules by human melanoma cells required a cross-presentation mechanism. Surprisingly, the classical endogenous processing pathway did not process this MMP-2 epitope. METHODOLOGY/PRINCIPAL FINDINGS: By PCR directed mutagenesis we showed that disruption of a single disulfide bond induced MMP-2 epitope presentation. By Pulse-Chase experiment, we demonstrated that disulfide bonds stabilized MMP-2 and impeded its degradation. Finally, using drugs, we documented that mutated MMP-2 epitope presentation used the proteasome and retrotranslocation complex. CONCLUSIONS/SIGNIFICANCE: These data appear crucial to us since they established the existence of a new inhibitory mechanism for the generation of a T cell epitope. In spite of MMP-2 classified as a self-antigen, the fact that cross-presentation is the only way to present this MMP-2 epitope underlines the importance to target this type of antigen in immunotherapy protocols.


Assuntos
Epitopos/imunologia , Antígenos de Histocompatibilidade Classe I/imunologia , Metaloproteinase 2 da Matriz/imunologia , Animais , Western Blotting , Células COS , Linhagem Celular Tumoral , Chlorocebus aethiops , Eletroforese em Gel de Poliacrilamida , Epitopos/genética , Antígenos de Histocompatibilidade Classe I/genética , Humanos , Imuno-Histoquímica , Metaloproteinase 2 da Matriz/genética
10.
J Med Chem ; 53(3): 1172-89, 2010 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-20055453

RESUMO

Indoleamine 2,3-dioxygenase (IDO) is an important therapeutic target for the treatment of diseases such as cancer that involve pathological immune escape. We have used the evolutionary docking algorithm EADock to design new inhibitors of this enzyme. First, we investigated the modes of binding of all known IDO inhibitors. On the basis of the observed docked conformations, we developed a pharmacophore model, which was then used to devise new compounds to be tested for IDO inhibition. We also used a fragment-based approach to design and to optimize small organic molecule inhibitors. Both approaches yielded several new low-molecular weight inhibitor scaffolds, the most active being of nanomolar potency in an enzymatic assay. Cellular assays confirmed the potential biological relevance of four different scaffolds.


Assuntos
Proliferação de Células/efeitos dos fármacos , Desenho de Fármacos , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Indolamina-Pirrol 2,3,-Dioxigenase/antagonistas & inibidores , Animais , Células Cultivadas , Inibidores Enzimáticos/síntese química , Humanos , Cinurenina/metabolismo , Camundongos , Modelos Moleculares , Bibliotecas de Moléculas Pequenas , Relação Estrutura-Atividade , Triptofano/metabolismo
11.
Cancer Immunol Immunother ; 57(5): 745-52, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18097665

RESUMO

Melan-A/MART1 is a melanocytic differentiation antigen recognized on melanoma tumor cells by CD8+ and CD4+ T cells. In this study, we describe a new epitope of this protein recognized in the context of HLA-Cw*0701 molecules by a CD8+ tumor infiltrating lymphocyte (TIL) clone. This CD8+ TIL clone specifically recognized and killed a fraction of melanoma cells lines expressing Melan-A/MART1 and HLA-Cw*0701. We further show that the Melan-A/MART1(51-61) peptide is the optimal peptide recognized by this clone. Together, these data significantly enlarge the fraction of melanoma patients susceptible to benefit from a Melan-A/MART1 vaccine approach.


Assuntos
Antígenos de Neoplasias/imunologia , Linfócitos T CD8-Positivos/imunologia , Epitopos de Linfócito T/imunologia , Antígenos HLA-C/imunologia , Linfócitos do Interstício Tumoral/imunologia , Melanoma/imunologia , Proteínas de Neoplasias/imunologia , Sequência de Aminoácidos , Apresentação de Antígeno/imunologia , Antígenos de Neoplasias/química , Antígenos de Neoplasias/genética , Epitopos de Linfócito T/química , Epitopos de Linfócito T/genética , Citometria de Fluxo , Humanos , Ativação Linfocitária/imunologia , Antígeno MART-1 , Dados de Sequência Molecular , Proteínas de Neoplasias/química , Proteínas de Neoplasias/genética
12.
Bioconjug Chem ; 18(5): 1547-54, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17602511

RESUMO

The use of dendritic cells (DC) for the development of therapeutic cancer vaccines is attractive because of their unique ability to present tumor epitopes via the MHC class I pathway to induce cytotoxic CD8+ T lymphocyte responses. C-Type membrane lectins, DC-SIGN and the mannose receptor (MR), present on the DC surface, recognize oligosaccharides containing mannose and/or fucose and mediate sugar-specific endocytosis of synthetic oligolysine-based glycoclusters. We therefore asked whether a glycotargeting approach could be used to induce uptake and presentation of tumor antigens by DC. To this end, we designed and synthesized glycocluster conjugates containing a CD8+ epitope of the Melan-A/Mart-1 melanoma antigen. These glycocluster-Melan-A conjugates were obtained by coupling glycosynthons: oligosaccharyl-pyroglutamyl-beta-alanine derivatives containing either disaccharides, a dimannoside (Manalpha-6Man) or lactoside, or a Lewis oligosaccharide, to Melan-A 16-40 peptide comprising the 26-35 HLA-A2 restricted T cell epitope, extended with an oligolysine stretch at the C-terminal end. We showed by confocal microscopy and flow cytometry that fluorescent-labeled Melan-A glycoclusters containing either dimannoside or Lewis oligosaccharide were taken up by DC and concentrated in acidic vesicles; conversely lactoside glycopeptides were not at all taken up. Furthermore, using surface plasmon resonance, we showed that dimannoside and Lewis-Melan-A conjugates bind MR and DC-SIGN with high affinity. DC loaded with these conjugates, but not with the lactose-Melan-A conjugate, led to an efficient presentation of the Melan-A epitope eliciting a CD8+ T-lymphocyte response. These data suggest that synthetically designed glycocluster-tumor antigen conjugates may induce antigen cross-presentation by DC and represent a promising tool for the development of tumor vaccines.


Assuntos
Antígenos de Neoplasias/imunologia , Linfócitos T CD8-Positivos/imunologia , Vacinas Anticâncer/síntese química , Células Dendríticas/imunologia , Glicopeptídeos/síntese química , Antígenos de Neoplasias/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Vacinas Anticâncer/imunologia , Vacinas Anticâncer/uso terapêutico , Células Dendríticas/metabolismo , Endocitose , Epitopos de Linfócito T/imunologia , Epitopos de Linfócito T/metabolismo , Citometria de Fluxo , Corantes Fluorescentes/química , Glicopeptídeos/imunologia , Glicopeptídeos/uso terapêutico , Humanos , Lectinas Tipo C/metabolismo , Receptor de Manose , Lectinas de Ligação a Manose/metabolismo , Melanoma/tratamento farmacológico , Melanoma/imunologia , Melanoma/patologia , Microscopia Confocal , Oligossacarídeos/química , Polilisina/química , Receptores de Superfície Celular/metabolismo , Ressonância de Plasmônio de Superfície , Fatores de Tempo , Células Tumorais Cultivadas
13.
Cancer Immunol Immunother ; 56(10): 1565-75, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17318652

RESUMO

Melan-A/MART1 is a melanocytic differentiation antigen expressed by tumor cells of the majority of melanoma patients and, as such, is considered as a good target for melanoma immunotherapy. Nonetheless, the number of class I and II restricted Melan-A epitopes identified so far remains limited. Here we describe a new Melan-A/MART-1 epitope recognized in the context of HLA-DQa1*0101 and HLA-DQb1*0501, -DQb1*0502 or -DQb1*0504 molecules by a CD4+ T cell clone. This clone was obtained by in vitro stimulation of PBMC from a healthy donor by the Melan-A51-73 peptide previously reported to contain a HLA-DR4 epitope. The Melan-A51-73 peptide, therefore contains both HLA-DR4 and HLA-DQ5 restricted epitope. We further show that Melan-A51-63 is the minimal peptide optimally recognized by the HLA-DQ5 restricted CD4+ clone. Importantly, this clone specifically recognizes and kills tumor cell lines expressing Melan-A and either HLA-DQb1*0501, -DQb1*0504 or -DQb1*0502 molecules. Moreover, we could detect CD4+ T cells secreting IFN-gamma in response to Melan-A51-63 and Melan-A51-73 peptides among tumor infiltrating and blood lymphocytes from HLA-DQ5+ patients. This suggests that spontaneous CD4+ T cell responses against this HLA-DQ5 epitope occur in vivo. Together these data significantly increase the fraction of melanoma patients susceptible to benefit from a Melan-A class II restricted vaccine approach.


Assuntos
Antígenos de Neoplasias/imunologia , Epitopos de Linfócito T/imunologia , Melanoma/imunologia , Proteínas de Neoplasias/imunologia , Neoplasias Cutâneas/imunologia , Sequência de Aminoácidos , Apresentação de Antígeno , Antígenos de Neoplasias/química , Linfócitos T CD4-Positivos/imunologia , Linhagem Celular Tumoral , Mapeamento de Epitopos , Epitopos de Linfócito T/química , Antígenos HLA-DQ/imunologia , Cadeias alfa de HLA-DQ , Cadeias beta de HLA-DQ , Humanos , Antígeno MART-1 , Dados de Sequência Molecular , Proteínas de Neoplasias/química , Peptídeos/química , Peptídeos/imunologia
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